The patient with functional disease/malingering
The problem of the perception of pain, the patient’s potential advantages in having others perceive him as being the “victim” of a painful condition, and the inability of the physician to validly measure pain cause most examining physicians to delay the proper diagnosis of “psychogenic pain” and/or “central pain” to the potential detriment of all concerned. The detriment comes from the repetitive and redundant search for a nonexistent somatic cause for the pain and the institution of different unsuccessful treatments. In order for the physician to clearly understand the problem of functional disease and/or malingering it is essential to understand some basic modern concepts of pain, it is transmission, perception, and clinical presentation. In general, this was discussed in Chap. 1, and should be reviewed before reading further into this chapter.
KeywordsPain Behavior Conversion Hysteria Minnesota MUltiphasic Personality Inventory Pain Complaint Somatization Disorder
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